<!-- 各種お問い合わせ入力画面 -->
	<!-- InstanceEndEditable -->
	<div id="main">
		<!-- InstanceBeginEditable name="main" -->
		<h1 id="specialTitle">{$contentsTitle}</h1>
		<!-- siteContents -->
		<div id="siteContents">
			<p class="categoryTitle">各種お問い合わせ</p>
			<h1>お問い合わせ</h1>
			<!-- contentsBlock -->
			<div id="contentsBlock">
				<!-- contents -->
				<div id="contents">
					<div id="inqAllForm">
						<table id="inqAllTable">
				        	<tr>
				        		<th>お名前&nbsp;<span>[必須]</span></th>
					        	<td>
								<p><input type="text" value="{$Name}" name="Name" id="Name" class="nameInput required zenkaku" maxlength="30" style="ime-mode:active" /></p>
								<p class="errTxt" htmlfor="Name" generated="true" />
								</td>
					   		</tr>
							<tr>
								<th>年齢</th>
								<td>
								<select name="AgeKbn" id="AgeKbn">
									<option value="0" {if $AgeKbn == 0 } selected {/if}>選択してください</option>
									<option value="1" {if $AgeKbn == 1 } selected {/if}>18歳未満</option>
									<option value="2" {if $AgeKbn == 2 } selected {/if}>20歳未満</option>
									<option value="3" {if $AgeKbn == 3 } selected {/if}>20～24</option>
									<option value="4" {if $AgeKbn == 4 } selected {/if}>25～29</option>
									<option value="5" {if $AgeKbn == 5 } selected {/if}>30～34</option>
									<option value="6" {if $AgeKbn == 6 } selected {/if}>35～39</option>
									<option value="7" {if $AgeKbn == 7 } selected {/if}>40～49</option>
									<option value="8" {if $AgeKbn == 8 } selected {/if}>50～59</option>
									<option value="9" {if $AgeKbn == 9 } selected {/if}>60歳以上</option>
								</select>&nbsp;
								</td>
							</tr>
							<tr>
								<th>性別</th>
								<td>
									<input type="radio" name="Sex" id="Sex0" value="0" {if $Sex == 0 } checked {/if} />
									<label for="sex1">男性</label>
									<input type="radio" name="Sex" id="Sex1" value="1" {if $Sex == 1 } checked {/if}  />
									<label for="sex2">女性</label>&nbsp;
								</td>
							</tr>
							<tr>
								<th>結婚</th>
								<td>
									<input type="radio" name="Mrrg" id="Mrrg0" value="0" {if $Mrrg == 0 } checked {/if} />
									<label for="marriage1">独身</label>
									<input type="radio" name="Mrrg" id="Mrrg1" value="1 "{if $Mrrg == 1 } checked {/if}  />
									<label for="marriage2">既婚</label>&nbsp;
								</td>
							</tr>
							<tr>
								<th>ご職業</th>
								<td>
								<select name="JobKbn" id="JobKbn">
									<option value="0" {if $JobKbn == 0 } selected {/if}>選択してください</option>
									<option value="1" {if $JobKbn == 1 } selected {/if}>会社員</option>
									<option value="2" {if $JobKbn == 2 } selected {/if}>学生</option>
									<option value="3" {if $JobKbn == 3 } selected {/if}>自営業</option>
									<option value="4" {if $JobKbn == 4 } selected {/if}>無職</option>
									<option value="5" {if $JobKbn == 5 } selected {/if}>フリーター</option>
									<option value="6" {if $JobKbn == 6 } selected {/if}>その他</option>
								</select>&nbsp;
								</td>
							</tr>
							<tr>
								<th>ご住所</th>
								<td>
									<p>〒&nbsp;<input type="text" name="Zip1" value="{$Zip1}" id="Zip1" maxlength="3" class="addnoInput number" style="IME-MODE: disabled" />－<input type="text" name="Zip2" value="{$Zip2}" id="Zip2" maxlength="4" class="addnoInput number" style="IME-MODE: disabled" /></p>
									<p class="pref01">都道府県&nbsp;
									<select name="PrefCd" id="PrefCd">
										<option value="00" {if $PrefCd == "00" } selected {/if}>選択して下さい</option>
										<option value="01" {if $PrefCd == "01" } selected {/if}>北海道</option>
										<option value="02" {if $PrefCd == "02" } selected {/if}>青森県</option>
										<option value="03" {if $PrefCd == "03" } selected {/if}>岩手県</option>
										<option value="04" {if $PrefCd == "04" } selected {/if}>宮城県</option>
										<option value="05" {if $PrefCd == "05" } selected {/if}>秋田県</option>

										<option value="06" {if $PrefCd == "06" } selected {/if}>山形県</option>
										<option value="07" {if $PrefCd == "07" } selected {/if}>福島県</option>
										<option value="08" {if $PrefCd == "08" } selected {/if}>茨城県</option>
										<option value="09" {if $PrefCd == "09" } selected {/if}>栃木県</option>
										<option value="10" {if $PrefCd == "10" } selected {/if}>群馬県</option>
										<option value="11" {if $PrefCd == "11" } selected {/if}>埼玉県</option>

										<option value="12" {if $PrefCd == "12" } selected {/if}>千葉県</option>
										<option value="13" {if $PrefCd == "13" } selected {/if}>東京都</option>
										<option value="14" {if $PrefCd == "14" } selected {/if}>神奈川県</option>
										<option value="15" {if $PrefCd == "15" } selected {/if}>新潟県</option>
										<option value="16" {if $PrefCd == "16" } selected {/if}>富山県</option>
										<option value="17" {if $PrefCd == "17" } selected {/if}>石川県</option>

										<option value="18" {if $PrefCd == "18" } selected {/if}>福井県</option>
										<option value="19" {if $PrefCd == "19" } selected {/if}>山梨県</option>
										<option value="20" {if $PrefCd == "20" } selected {/if}>長野県</option>
										<option value="21" {if $PrefCd == "21" } selected {/if}>岐阜県</option>
										<option value="22" {if $PrefCd == "22" } selected {/if}>静岡県</option>
										<option value="23" {if $PrefCd == "23" } selected {/if}>愛知県</option>

										<option value="24" {if $PrefCd == "24" } selected {/if}>三重県</option>
										<option value="25" {if $PrefCd == "25" } selected {/if}>滋賀県</option>
										<option value="26" {if $PrefCd == "26" } selected {/if}>京都府</option>
										<option value="27" {if $PrefCd == "27" } selected {/if}>大阪府</option>
										<option value="28" {if $PrefCd == "28" } selected {/if}>兵庫県</option>
										<option value="29" {if $PrefCd == "29" } selected {/if}>奈良県</option>

										<option value="30" {if $PrefCd == "30" } selected {/if}>和歌山県</option>
										<option value="31" {if $PrefCd == "31" } selected {/if}>鳥取県</option>
										<option value="32" {if $PrefCd == "32" } selected {/if}>島根県</option>
										<option value="33" {if $PrefCd == "33" } selected {/if}>岡山県</option>
										<option value="34" {if $PrefCd == "34" } selected {/if}>広島県</option>
										<option value="35" {if $PrefCd == "35" } selected {/if}>山口県</option>
										<option value="36" {if $PrefCd == "36" } selected {/if}>徳島県</option>
										<option value="37" {if $PrefCd == "37" } selected {/if}>香川県</option>
										<option value="38" {if $PrefCd == "38" } selected {/if}>愛媛県</option>
										<option value="39" {if $PrefCd == "39" } selected {/if}>高知県</option>
										<option value="40" {if $PrefCd == "40" } selected {/if}>福岡県</option>
										<option value="41" {if $PrefCd == "41" } selected {/if}>佐賀県</option>

										<option value="42" {if $PrefCd == "42" } selected {/if}>長崎県</option>
										<option value="43" {if $PrefCd == "43" } selected {/if}>熊本県</option>
										<option value="44" {if $PrefCd == "44" } selected {/if}>大分県</option>
										<option value="45" {if $PrefCd == "45" } selected {/if}>宮崎県</option>
										<option value="46" {if $PrefCd == "46" } selected {/if}>鹿児島県</option>
										<option value="47" {if $PrefCd == "47" } selected {/if}>沖縄県</option>

										</select>
										</p>
										<p class="pref02"><input type="text" name="Address" value="{$Address}" id="Address" maxlength="50" class="normalInput" style="ime-mode:active" /></p>
									</td>
								</tr>
								<tr>
									<th>電話番号</th>
									<td>
										<input type="text" name="Tel1" value="{$Tel1}" id="Tel1" maxlength="4" class="telInput number" style="IME-MODE: disabled" />
										－
										<input type="text" name="Tel2" value="{$Tel2}" id="Tel2" maxlength="4" class="telInput number" style="IME-MODE: disabled" />
										－
										<input type="text" name="Tel3" value="{$Tel3}" id="Tel3" maxlength="4" class="telInput number" style="IME-MODE: disabled" />
									</td>
								</tr>
								<tr>
									<th>FAX</th>
									<td>
										<input type="text" name="Fax1" value="{$Fax1}" id="Fax1" maxlength="4" class="telInput number" style="IME-MODE: disabled" />
										－
										<input type="text" name="Fax2" value="{$Fax2}" id="Fax2" maxlength="4" class="telInput number" style="IME-MODE: disabled" />
										－
										<input type="text" name="Fax3" value="{$Fax3}" id="Fax3" maxlength="4" class="telInput number" style="IME-MODE: disabled" />
									</td>
								</tr>
							<!-- E-mail -->
							<tr>
						       	<th>メールアドレス&nbsp;<span>[必須]</span></th>
				        		<td>
								<p><input type="text" name="Mail" value="{$Mail}" id="Mail" maxlength="50" class="normalInput required email alphanum" style="IME-MODE: disabled" />								</p>
								<p class="errTxt" htmlfor="Mail" generated="true" />
								</td>
				       		</tr>
				        	<tr>
				        		<th>種別&nbsp;<span>[必須]</span></th>
				        		<td>
				         			<select name="TargetKbn" id="TargetKbn" class="required">
				         				<option value="" selected="selected">選択して下さい</option>
										<option value="101" {if $TargetKbn == "101" } selected {/if}>接客</option>
										<option value="102" {if $TargetKbn == "102" } selected {/if}>物件</option>
										<option value="103" {if $TargetKbn == "103" } selected {/if}>賃料</option>
										<option value="104" {if $TargetKbn == "104" } selected {/if}>環境</option>
										<option value="105" {if $TargetKbn == "105" } selected {/if}>HP</option>
										<option value="106" {if $TargetKbn == "106" } selected {/if}>i-mode</option>
										<option value="107" {if $TargetKbn == "107" } selected {/if}>SoftBank</option>
										<option value="108" {if $TargetKbn == "108" } selected {/if}>EZ-Web</option>
										<option value="109" {if $TargetKbn == "109" } selected {/if}>PDA</option>
										<option value="199" {if $TargetKbn == "199" } selected {/if}>その他</option>
									</select>
								<p class="errTxt" htmlfor="TargetKbn" generated="true" />
								</td>
	                		</tr>
							<!-- ｸﾚｰﾑ対象 -->
							<tr>
				        		<th>対象&nbsp;<span>[必須]</span></th>
				        		<td>
									<input type="radio" name="ClaimTgtKbn" id="ClaimTgtKbn1" value="1" {if $ClaimTgtKbn == "1" } checked {/if}/>
									<label for="ClaimTgtKbn1">アパマンショップネットワーク　フランチャイズ本部</label><br />
									<input type="radio" name="ClaimTgtKbn" id="ClaimTgtKbn2" value="2" {if $ClaimTgtKbn == "2" || $ClaimTgtKbn == ""} checked {/if} />
									<label for="ClaimTgtKbn2">店舗</label>
										<input type="text" name="TenpoNm" id="TenpoNm" value="{$TenpoNm}" size="20" maxlength="50" readonly />
										<input type="button" onclick="javascript:selectTenpo()" name="tenpo_sentaku2" value="店舗選択" />
										担当者
										<input type="text" name="Charge" id="Charge" value="{$Charge}" size="20" maxlength="50" style="ime-mode:active" />
										<br />
									<input type="radio" name="ClaimTgtKbn" id="ClaimTgtKbn3" value="3" {if $ClaimTgtKbn == "3"} checked {/if} />
									<label for="ClaimTgtKbn3">その他</label>
								<p class="errTxt" htmlfor="taisho" generated="true" />
								<p class="errTxt" htmlfor="TenpoNm" generated="true" />
								<input type="hidden" id="ClaimTgtKbnNm" name="ClaimTgtKbnNm" value="{$ClaimTgtKbnNm}" />
								<input type="hidden" id="TenpoPrefCd" name="TenpoPrefCd" value="{$TenpoPrefCd}" />
								</td>
							</tr>
							<!-- ご意見･ご感想 -->
							<tr>
								<th>ご意見・ご感想&nbsp;<span>[必須]</span><br />
									<span class="attTxt">(400字以内でお願い致します)</span>
								</th>
								<td>
									<textarea name="Comment"  id="Comment" class="required maxlength" maxlength="400" cols="40" rows="10" style="ime-mode:active">{$Comment}</textarea>
									<p class="errTxt" htmlfor="Comment" generated="true" />
								</td>
		       				</tr>
				       	</table>
						<p id="privacyTxt">▼必ずお読みください。</p>
						<div id="privacyTitle">
							<p class="txt">個人情報の取り扱いについて</p>
							<p class="link"><a href="http://www.fcapamanshop.com/privacy.html" target="_blank">別ウィンドウで見る</a></p>
						</div>
						<div id="privacyContents">
							<iframe width="100%" scrolling="auto" height="165" frameborder="no" src="/app/html/inquiry/privacy.html" id="privacy"></iframe>
						</div>
						<table class="footTable">
							<tbody>
								<tr>
									<td></td>
									<td class="pointTxt">
										<a href="javascript:void(0);" onclick="javascript:etcEntrySubmit(); return false;" class="links">入力内容を確認して送信</a>
									</td>
									<td>
										<a href="javascript:void(0);">
										<img width="271" height="66" class="rollImg" alt="「個人情報の取り扱いについて」に同意の上今すぐ送信" src="/images/search/detail/btn_send_now.jpg"onclick="javascript:etcSendSubmit(); return false;" />
										</a>
									</td>
								</tr>
								<tr>
									<td colspan="3" class="attTd02">SSL暗号化通信を使用してますので、安心して個人情報を送信いただけます。</td>
								</tr>
						</table>
					</div>
					<!-- /inqAllForm -->
				<!-- /contents -->
				</div>
				<!-- side -->
				<div id="side">
					<!-- sideNavi -->
					<div id="sideNavi">
						<ul class="first">
							<li><a href="{$baseurl}opinion/index.html">各種お問い合わせTOP</a></li>
							<li class="current"><a href="#">お問い合わせ</a></li>
							<li><a href="https://wwws.apamanshop-secure.com/inquiry/cojp/publicity/entry.asp" target="_blank">広報窓口</a></li>
							<li><a href="javascript:openWin2('/help/dic/index.html','help','width=540,height=500');">不動産用語について</a></li>
						</ul>
					</div>
					<!-- /sideNavi -->
				</div>
				<!-- /side -->
			</div>
			<!-- /contentsBlock -->
		</div>
		<!-- /siteContents -->
		<!-- InstanceEndEditable -->
	</div>
<!-- 必要パラメータにあがっているがINPUTに無い要素　ここから -->
<!-- TargetNm -->
<!-- 必要パラメータにあがっているがINPUTに無い要素　ここまで -->
<!-- 共通パラメータここから -->
<input type="hidden" id="CntctWayFax" name="CntctWayFax" value="{$CntctWayFax}" />
<input type="hidden" id="CntctWayMail" name="CntctWayMail" value="{$CntctWayMail}" />
<input type="hidden" id="CntctWayTel" name="CntctWayTel" value="{$CntctWayTel}" />
<input type="hidden" id="CntctWayCd" name="CntctWayCd" value="{$CntctWayCd}" />
<input type="hidden" id="CntctWayStr" name="CntctWayStr" value="{$CntctWayStr}" />
<input type="hidden" id="Fax" name="Fax" value="{$Fax}" />
<input type="hidden" id="Inquiry1" name="Inquiry1" value="{$Inquiry1}" />
<input type="hidden" id="Inquiry2" name="Inquiry2" value="{$Inquiry2}" />
<input type="hidden" id="Inquiry3" name="Inquiry3" value="{$Inquiry3}" />
<input type="hidden" id="Inquiry4" name="Inquiry4" value="{$Inquiry4}" />
<input type="hidden" id="Inquiry5" name="Inquiry5" value="{$Inquiry5}" />
<!-- <input type="hidden" id="Mail" name="Mail" value="{$Mail}" /> -->
<input type="hidden" id="MailMgznFlg" name="MailMgznFlg" value="{$MailMgznFlg}" />
<!-- <input type="hidden" id="Name" name="Name" value="{$Name}" /> -->
<input type="hidden" id="NameMei" name="NameMei" value="{$NameMei}" />
<input type="hidden" id="NameSei" name="NameSei" value="{$NameSei}" />
<input type="hidden" id="KanaSei" name="KanaSei" value="{$KanaSei}" />
<input type="hidden" id="KanaMei" name="KanaMei" value="{$KanaMei}" />
<input type="hidden" id="NeedTimeKbn" name="NeedTimeKbn" value="{$NeedTimeKbn}" />
<input type="hidden" id="PlaceKbn" name="PlaceKbn" value="{$PlaceKbn}" />
<input type="hidden" id="ShopCd" name="ShopCd" value="{$ShopCd}" />
<input type="hidden" id="Tel" name="Tel" value="{$Tel}" />
<input type="hidden" id="UseKbn" name="UseKbn" value="{$UseKbn}" />
<input type="hidden" id="SrhKbn" name="SrhKbn" value="{$SrhKbn}" />
<input type="hidden" id="OemCd" name="OemCd" value="{$OemCd}" />
<input type="hidden" id="Url" name="Url" value="{$Url}" />
<input type="hidden" id="Company" name="Company" value="{$Company}" />
<!-- CtgryCd　パラメータ渡ってくるまでベタうち -->
<input type="hidden" id="CtgryCd" name="CtgryCd" value="01" />
<!-- <input type="hidden" id="ClaimTgtKbn" name="ClaimTgtKbn" value="{$ClaimTgtKbn}" /> -->
<!-- <input type="hidden" id="Mrrg" name="Mrrg" value="{$Mrrg}" /> -->
<input type="hidden" id="MrrgNm" name="MrrgNm" value="{$MrrgNm}" />
<input type="hidden" id="BuyExp" name="BuyExp" value="{$BuyExp}" />
<input type="hidden" id="BuyExpNm" name="BuyExpNm" value="{$BuyExpNm}" />
<!-- <input type="hidden" id="Comment" name="Comment" value="{$Comment}" /> -->
<input type="hidden" id="Other" name="Other" value="{$Other}" />
<!-- SiteKbn　パラメータ渡ってくるまでベタうち -->
<input type="hidden" id="SiteKbn" name="SiteKbn" value="1" />
<!-- <input type="hidden" id="Address" name="Address" value="{$Address}" /> -->
<input type="hidden" id="Address1" name="Address1" value="{$Address1}" />
<input type="hidden" id="Address2" name="Address2" value="{$Address2}" />
<!-- <input type="hidden" id="JobKbn" name="JobKbn" value="{$JobKbn}" /> -->
<input type="hidden" id="JobNm" name="JobNm" value="{$JobNm}" />
<!-- <input type="hidden" id="Sex" name="Sex" value="{$Sex}" /> -->
<input type="hidden" id="SexNm" name="SexNm" value="{$SexNm}" />
<!-- <input type="hidden" id="Charge" name="Charge" value="{$Charge}" /> -->
<input type="hidden" id="ChargeNm" name="ChargeNm" value="{$ChargeNm}" />
<input type="hidden" id="ChargeNmKana" name="ChargeNmKana" value="{$ChargeNmKana}" />
<!-- <input type="hidden" id="TenpoNm" name="TenpoNm" value="{$TenpoNm}" /> -->
<input type="hidden" id="TenpoMail" name="TenpoMail" value="{$TenpoMail}" />
<!-- <input type="hidden" id="PrefCd" name="PrefCd" value="{$PrefCd}" /> -->
<input type="hidden" id="PrefName" name="PrefName" value="{$PrefName}" />
<!-- <input type="hidden" id="AgeKbn" name="AgeKbn" value="{$AgeKbn}" /> -->
<input type="hidden" id="AgeNm" name="AgeNm" value="{$AgeNm}" />
<input type="hidden" id="Busho" name="Busho" value="{$Busho}" />
<input type="hidden" id="BukkenCd" name="BukkenCd" value="{$BukkenCd}" />
<input type="hidden" id="Matrix" name="Matrix" value="{$Matrix}" />
<input type="hidden" id="Yakushoku" name="Yakushoku" value="{$Yakushoku}" />
<input type="hidden" id="Zip" name="Zip" value="{$Zip}" />
<!-- <input type="hidden" id="Zip1" name="Zip1" value="{$Zip1}" /> -->
<!-- <input type="hidden" id="Zip2" name="Zip2" value="{$Zip2}" /> -->
<!-- <input type="hidden" id="TargetKbn" name="TargetKbn" value="{$TargetKbn}" /> -->
<input type="hidden" id="TargetNm" name="TargetNm" value="{$TargetNm}" />
<input type="hidden" id="ComId" name="ComId" value="{$ComId}" />
<input type="hidden" id="HikkoshiRiyuuText" name="HikkoshiRiyuuText" value="{$HikkoshiRiyuuText}" />
<input type="hidden" id="HikkoshiRiyuu" name="HikkoshiRiyuu" value="{$HikkoshiRiyuu}" />
<input type="hidden" id="HikkoshiRiyuuSonota" name="HikkoshiRiyuuSonota" value="{$HikkoshiRiyuuSonota}" />
<input type="hidden" id="NeedTokushuuText" name="NeedTokushuuText" value="{$NeedTokushuuText}" />
<input type="hidden" id="NeedTokushuu" name="NeedTokushuu" value="{$NeedTokushuu}" />
<input type="hidden" id="NeedTokushuuSonota" name="NeedTokushuuSonota" value="{$NeedTokushuuSonota}" />
<input type="hidden" id="KounyuuKeikenText" name="KounyuuKeikenText" value="{$KounyuuKeikenText}" />
<input type="hidden" id="KounyuuKeiken" name="KounyuuKeiken" value="{$KounyuuKeiken}" />
<input type="hidden" id="SonotaZassiText" name="SonotaZassiText" value="{$SonotaZassiText}" />
<input type="hidden" id="SonotaZassi" name="SonotaZassi" value="{$SonotaZassi}" />
<input type="hidden" id="SonotaZassiName" name="SonotaZassiName" value="{$SonotaZassiName}" />
<input type="hidden" id="SoufuKibouJyouhoushiText" name="SoufuKibouJyouhoushiText" value="{$SoufuKibouJyouhoushiText}" />
<input type="hidden" id="SoufuKibouJyouhoushi" name="SoufuKibouJyouhoushi" value="{$SoufuKibouJyouhoushi}" />
<input type="hidden" id="KikkakeText" name="KikkakeText" value="{$KikkakeText}" />
<input type="hidden" id="Kikkake" name="Kikkake" value="{$Kikkake}" />
<input type="hidden" id="KikkakeSonota" name="KikkakeSonota" value="{$KikkakeSonota}" />
<input type="hidden" id="JyuushiKoumokuText" name="JyuushiKoumokuText" value="{$JyuushiKoumokuText}" />
<input type="hidden" id="JyuushiKoumoku" name="JyuushiKoumoku" value="{$JyuushiKoumoku}" />
<input type="hidden" id="JyuushiKoumokuSonota" name="JyuushiKoumokuSonota" value="{$JyuushiKoumokuSonota}" />
<input type="hidden" id="FavFlg" name="FavFlg" value="{$FavFlg}" />
<input type="hidden" id="Did" name="Did" value="{$Did}" />
<input type="hidden" id="Sid" name="Sid" value="{$Sid}" />
<input type="hidden" id="UAKbn" name="UAKbn" value="{$UAKbn}" />
<input type="hidden" id="CampaignLocationFlg" name="CampaignLocationFlg" value="{$CampaignLocationFlg}" />
<input type="hidden" id="TimeStr" name="TimeStr" value="{$TimeStr}" />
<!-- 共通パラメータここまで -->